De Schepper E. Usefulness of lumbar MRI in general practice. Huisarts Wet 2017;60(1):21-3. General practitioners (GPs) in the Netherlands can now refer patients for MRI of the lumbar spine, but as yet there are no data on its use. For this reason, this cohort study investigated the use of lumbar MRI by Dutch GPs. One of the most striking findings was that at the time of referral most patients had had lasting symptoms and complaints for a long time. Furthermore, the MRI reports indicated that there were a relatively high number of disc pathologies. The MRI findings did not influence the GP’s decision to refer a patient to a specialist or the prognosis regarding recovery. From a clinical perspective, these results raise a number of questions about the usefulness of lumbar MRI in general practice. In order to establish whether MRI of the lumbar spine should be used as diagnostic instrument in primary care or restricted to secondary care, a well-designed randomized trial of diagnostic accuracy and cost-effectiveness is required. Until then, GPs are advised to follow the recommendations of the relevant Dutch College of General Practitioner’s guideline, which advises against diagnostic imaging in primary care.
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© 2017, Bohn Stafleu van Loghum.